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Article

Socioeconomic Disadvantage, Residential Remoteness and Access to Specialised Interventions in Cerebral Palsy: A Cross-Sectional Study

by
Simon P. Paget
1,2,*,
Kirsty Stewart
1,2,
Lisa Copeland
3,
Emma Waight
4,
Nadine Smith
5,6,
Felicity Baker
7,
Jennifer Lewis
2 and
Australian Selective Dorsal Rhizotomy Research Group
† on behalf of the Australian Paediatric Intrathecal Baclofen Research
1
Children’s Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
2
Kids Rehab, The Children’s Hospital at Westmead, Locked Bag 4001, Sydney, NSW 2145, Australia
3
Queensland Paediatric Rehabilitation Service, Queensland Children’s Hospital, Children’s Health Queensland, Brisbane, QLD 4101, Australia
4
Cerebral Palsy Alliance/Research Institute, Specialty of Child & Adolescent Health, The University of Sydney, Sydney, NSW 2050, Australia
5
Perth Children’s Hospital, Departments of Physiotherapy and Kids Rehab, Perth, WA 6009, Australia
6
Division of Paediatrics, Medical School, University of Western Australia, Perth, WA 6009, Australia
7
Women’s and Children’s Health Network, Adelaide, SA 5006, Australia
*
Author to whom correspondence should be addressed.
†
Membership of the Australian Selective Dorsal Rhizotomy Research Group and Australian Paediatric Intrathecal Baclofen Research Group are indicated in Acknowledgments.
J. Clin. Med. 2025, 14(10), 3579; https://doi.org/10.3390/jcm14103579
Submission received: 1 April 2025 / Revised: 6 May 2025 / Accepted: 14 May 2025 / Published: 20 May 2025
(This article belongs to the Special Issue Toward Improved Evaluation, Treatment, and Management of Movement Disorders and Cognitive Impairments in People with Cerebral Palsy)
Review Reports Versions Notes

Abstract

Aim: Socioeconomic factors are known to influence access to health services, including for children with cerebral palsy (CP). This study aims to determine whether socioeconomic disadvantage and/or geographical remoteness influence access to specialised CP interventions: selective dorsal rhizotomy (SDR) and intrathecal baclofen (ITB). Methods: This was a cross-sectional study of children with CP from (i) the Australian SDR Research Registry and (ii) an Australian ITB audit study. Socioeconomic disadvantage was grouped (quintiles) using the Index of Relative Socioeconomic Disadvantage (IRSD). Geographical remoteness was determined using the Australian Statistical Geographical Standard. IRSD quintiles and remoteness were compared with the Australian CP Register (ACPR) (birth years 1995–2016). Results: A total of 64 children (31.3% female) had received SDR surgery and 52 children (48.1% female) had received ITB therapy. Of these, 7 (11.1%) (SDR) and 7 (13.5%) (ITB) lived in the most disadvantaged neighbourhoods (IRSD quintile 1); 41 children (65.1%) (SDR) and 42 (82.4%) (ITB) lived in major cities. In comparison, 1630 (18.8%) of children on the ACPR resided in IRSD quintile 1; 6122 (70.4%) resided in major cities. There were no statistical differences in IRSD distribution between ACPR, SDR, and ITB groups. More children in major cities received ITB therapy (p = 0.03) and more children in outer regional/remote areas had received SDR (p = 0.03). Conclusions: Access to SDR and ITB in Australia varies by geographical remoteness. Equity of access is important to monitor, and interventions should be considered to reduce inequity.
Keywords: cerebral palsy; socioeconomic disparities in health; baclofen; rhizotomy; health service accessibility cerebral palsy; socioeconomic disparities in health; baclofen; rhizotomy; health service accessibility

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MDPI and ACS Style

Paget, S.P.; Stewart, K.; Copeland, L.; Waight, E.; Smith, N.; Baker, F.; Lewis, J.; Australian Selective Dorsal Rhizotomy Research Group, on behalf of the Australian Paediatric Intrathecal Baclofen Research. Socioeconomic Disadvantage, Residential Remoteness and Access to Specialised Interventions in Cerebral Palsy: A Cross-Sectional Study. J. Clin. Med. 2025, 14, 3579. https://doi.org/10.3390/jcm14103579

AMA Style

Paget SP, Stewart K, Copeland L, Waight E, Smith N, Baker F, Lewis J, Australian Selective Dorsal Rhizotomy Research Group on behalf of the Australian Paediatric Intrathecal Baclofen Research. Socioeconomic Disadvantage, Residential Remoteness and Access to Specialised Interventions in Cerebral Palsy: A Cross-Sectional Study. Journal of Clinical Medicine. 2025; 14(10):3579. https://doi.org/10.3390/jcm14103579

Chicago/Turabian Style

Paget, Simon P., Kirsty Stewart, Lisa Copeland, Emma Waight, Nadine Smith, Felicity Baker, Jennifer Lewis, and Australian Selective Dorsal Rhizotomy Research Group on behalf of the Australian Paediatric Intrathecal Baclofen Research. 2025. "Socioeconomic Disadvantage, Residential Remoteness and Access to Specialised Interventions in Cerebral Palsy: A Cross-Sectional Study" Journal of Clinical Medicine 14, no. 10: 3579. https://doi.org/10.3390/jcm14103579

APA Style

Paget, S. P., Stewart, K., Copeland, L., Waight, E., Smith, N., Baker, F., Lewis, J., & Australian Selective Dorsal Rhizotomy Research Group, on behalf of the Australian Paediatric Intrathecal Baclofen Research. (2025). Socioeconomic Disadvantage, Residential Remoteness and Access to Specialised Interventions in Cerebral Palsy: A Cross-Sectional Study. Journal of Clinical Medicine, 14(10), 3579. https://doi.org/10.3390/jcm14103579

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